Quadrants & Tender Points
The Four Quadrants
The "Fibromyalgia
Defined" area pointed out that in order to meet the criteria established by
the American College of Rheumatology, the pain must have been present
for at least 3 months' duration, and must be present in all 4 quadrants of
the body.
What exactly is a quadrant? Imagine dividing the body into four quarters:
|
(1)
|
Right side - above the waist | |
|
(2)
|
Left side - above the waist | |
|
(3)
|
Right side - below the waist | |
|
(4)
|
Left side - below the waist |
Anatomical Tender Points |
||
|
(1)
|
Occiput: bilateral, at the suboccipital muscle insertions. | |
|
(2)
|
Low cervical: bilateral, at the anterior aspects of the inter-transverse spaces at C5-C7. | |
|
(3)
|
Trapezius: bilateral, at the midpoint of the upper border. | |
|
(4)
|
Supraspinatus: bilateral, at origins, above the scapula spine near the medial border. | |
|
(5)
|
2nd rib: bilateral, at the second costochondral junctions, just lateral on upper surfaces. | |
|
(6)
|
Lateral epicondyle: bilateral, 2 cm distal to the epicondyles. | |
|
(7)
|
Gluteal: bilateral, in upper outer quadrants of buttocks in anterior fold of muscle. | |
|
(8)
|
Greater trochanter: bilateral, posterior to the trochanteric prominence. | |
|
(9)
|
Knees: bilateral, at the medial fat pad proximal to the joint line. | |
